African Sleeping Sickness in Tourists Returning from Tanzania: The First 2 Italian Cases from a Small Outbreak among European Travelers

A recent cluster of cases of African trypanosomiasis in humans (HAT) has been reported in tourists (most of whom were European) returning from Tanzania; we describe the first 2 patients (both of whom were Italian travelers) with HAT, who have been treated successfully. Because neither vaccine nor drug prophylaxis is currently recommended and/ or available for persons traveling to areas of endemicity, physicians should be alerted about this uncommon but potentially life-threatening disease. African trypanosomiasis in humans (HAT) is a protozoan disease caused by Trypanosoma brucei complex, which is transmitted by infected tsetse flies belonging to the genus Glossina. These insects, which are not found outside of Africa, acquire the infection by sucking the blood of wild and domestic infected animals. The illness (also known as “sleeping sickness”) may spread to the CNS during the late stage of disease. If untreated, it leads to coma and death [1]. It is estimated that at least 300,000 patients are currently infected with HAT in central Africa, and that 160 million persons live in areas where they are considered to be at high risk of infection [2, 3]. Although HAT is persistently endemic in the African continent, and although there has been a recent resurgence in infection [4], only a small number of cases (!15) have been reported in international travelers during the past 15 years. Most of these infected travelers had returned from short trips to national parks in Africa [5‐15]. However, from